Global Reproductive Health Diaries: Personal Stories from Around the World
While the stories below represent experiences of real women and men from around the globe, the names of the characters and the illustrations depicted here are fiction.
If you or someone you know has experienced challenges accessing prevention for sexually transmitted infections (STIs) and/or adequate family planning/contraception or if you have personal experience as a clinician, share your own story by sending an email to info@cami-health.org. Please include your age and geographic location; we will keep your personal identity confidential. Feel free to send in a question, and we will do our best to respond to all questions in the discussion section.
Marjan, age 43, Iran
"I work at a clinic in Iran. Once we had a woman come in who had eight children, and both she and her husband were not ready for more, at least not yet. She wasn’t sure how to prevent unwanted pregnancy, so we gave her a supply of condoms to bring home for her husband. A few months after that visit, her husband showed up, complaining of horrible stomach pains. We did some scans and decided we had to operate. What we found was incredible—hundreds of condoms in his intestines. Astonished, we realized that neither husband nor wife knew how to use the condoms, so he had been swallowing them with water. The necessity of taking the time to carefully explain, and in this case demonstrate, how to use existing prevention methods for family planning and STIs was never more apparent than at that moment. The reality was that neither this woman nor her husband had ever seen, let alone used, condoms. When it comes to people’s health and protection, you should never assume anything."
The photo above illustrates the importance of education about exactly how prevention tools ought to be used
Helene, age 33, Ivory Coast
"I have six children, and that is enough. I tried to tell my husband that I didn’t want to get pregnant again, but he doesn’t understand; he wants more children. When he is away, I go to the local health center to get the Depo injection so that I won’t become pregnant again. I considered going on the pill, too, but I would have to take it home, and then my husband would see it. So that is what I have to focus on, not getting pregnant—if I tried to talk about STDs with my husband, I know he would only get angry. I don’t feel comfortable asking him to wear condoms because he doesn’t like them, and he asks me why? what’s the point? and I don’t tell him I’m scared of getting infected because I’m also scared of his temper. I can’t question him, because he will take it as an accusation. But he goes into the city sometimes, and I don’t know what he does there. And he has two other wives, and I don’t know what they may be infected with."
Lauren, age 19, Wisconsin
"It’s my first year in college, so I’m incredibly busy and a little overwhelmed. It’s not a good time to be in a long-term relationship, but it’s nice to have a warm body to sleep next to sometimes. I mean, it’s not very often or with very many guys, and I always know them well and trust them. I really care about being safe. I tried going on the pill, but it doesn’t prevent against STDs and it made me gain weight, so I stopped using it. And the guys will wear condoms, but they don’t usually like it. Those two methods, condoms and the pill, are really the only two methods that people my age use and talk about. I want something else that I can really rely on, but right now I’m not really sure what that could be."
Clarissa, age 68. Ohio
"People don’t want to think about grandparents having sex. Well, I’ve been divorced for a while, and I’ve had boyfriends. But protection is not something I feel very comfortable talking about with them or even to my doctor who is so much younger than I am. And since people seem to be focused on unwanted pregnancies, boyfriends tend to think of protection as a problem of the past since we can no longer get pregnant. But—there are still diseases. It makes me worry, but it’s hard to address that worry openly."
Justine, age 27, New York
"My biggest concern right now is protection against STDs. If you get an STD, you have to live with it and that’s hard enough, but then there’s the possibility that you won’t be able to live with it. I worry about pregnancy too, of course, but I’m not a teenager and I’m in a steady relationship, so it’s not my biggest worry. Still, if you’re a kid and you get pregnant—well, then that’s it. You have no choice but to stop your childhood short and grow up. I knew more than one girl who got pregnant around the age of twelve or thirteen. There’s so much more life to live—they’re practically babies themselves and then they have to raise one. So a good prevention technology is going to have to prevent against both STDs and pregnancy, and its gotta be easy, because people start earlier and earlier, and regardless of age, you just can’t trust that people are being as careful as they should."
Rachel, age 37, Connecticut
"The stage I’m in right now is getting back to the dating world, the having-sex-again world. The guys I’ve been with so far don’t mind using a condom. But that’s because they know me, they know my convictions; we’ve talked enough that they know that if they refuse to use one, then we’re not going to do it. And that’s their only choice. It’s a choice they’re not ecstatic about, to say the least. Ever since I became sexually active, I’ve had to deal with some partners trying to convince me that we don’t need to use a condom. And sometimes, I have been convinced. I’m lucky that I never had to deal with the consequences of that decision, but now that I’m older, I’m more stubborn, and that’s a good thing. I can’t imagine how many women out there don’t feel comfortable insisting on using a condom—guys can be persuasive. I mean, your safety should come first, but in the moment, it doesn’t always."
Akissa, age 27, South Africa
"Too many people around me are infected with HIV, and it makes me worry. I have a boyfriend in the city. We live far apart and only see each other about once a month, so—I am not sure who else he may have been with. Once I tried to tell him that I was worried about getting HIV, and other diseases, too. He only got upset, and he accused me of being with other men, but I remain faithful to him even when it is not easy to do so. I have stopped worrying about diseases because I have no choice. And we don’t ever talk about this kind of stuff anymore. No one does. I have two children, and I know that soon enough they will be older and then they will be at risk, and that scares me so much. But what can I do?"
Jack, age 20, Oregon
"I’ve been with my girlfriend for about a year now, and we’re still trying to find a method that will work for us. I care as much as she does about protection, and I want to take part in figuring this out. She was on the pill at first, but she didn’t like the way it made her body feel. We even talked about an IUD but she doesn’t feel comfortable either talking about it with her parents or getting one without them knowing. And we keep meaning to get tested, just in case, but we still haven’t gotten around to it. So I wear condoms, of course, but I’m sick of them. Wouldn’t it be cool if there were something else that is not a condom, but is just as easy?"
Sohni, age 30, India
"People are afraid of getting pregnant because there is this real fear of unsafe delivery. Mothers really can die in childbirth, and it’s scary. My sister was one of them. She was only twenty-seven. Her baby, who lived, was HIV infected when he was born, and my poor sister did not even know that she was at risk for HIV since she was monogamous. I guess her husband had other girlfriends, putting my trusting sister and their unborn child at risk for HIV. I am married with two children. My husband wants more children, so he doesn’t think we need to use contraception. I want to have more children too, but I also know that the closer you have them together, the greater your risk of unsafe delivery. I want to have more children, but I want to space them out; it will be easier on me and better for them and safer for us both. I don't think my husband is at risk for HIV, but I can't be sure, and I know he would be angry if I asked him to get tested. After seeing what happened to my sister and others around me, I wish there was something that could protect me against unplanned pregnancy and diseases, including HIV. "
Amy, age 26, Massachusetts
"I first became aware of STDs when I was eighteen; I never used condoms, and I got Chlamydia. It was a reality check that came too late to be preventative. At least Chlamydia is something that’s fixable if you catch it early, which, luckily enough, was the case for me. Of course, since then I’ve been really responsible; I’ve been on the pill for years even though I don’t really like the way it makes my body feel. And I’ve always used condoms, too. I have a steady boyfriend now, and he never wanted to use them. He hates them and says they take away the sensation, but I always made him use one until we both got tested. But the only reason I was so forceful about it was because I had this horrific, real-life experience when I was only eighteen. And if I hadn’t? Who knows if I would still be this responsible."
Lydia, age 48, Russia
"I was a young woman in the 1980s in the Soviet Union, coming of age in a time when contraception was essentially unavailable, and the result was that abortion became a widely-used method of contraception. I knew people who were having many abortions or who were getting diseases because they weren’t using protection. Abortions became frighteningly more normal than they should have been, even for married women who sometimes used abortion as a means of family planning. And I had one, too, when I was twenty-two years old, young and husband-less and not realizing the emotional realities of it. I am thankful that times are changing, but I still worry constantly for my daughters who are growing up so quickly. It’s not about being pro-choice or pro-life; I think we should all be able to agree that safe and easily accessible methods of protection—from unwanted pregnancy and from STDs—are extremely important."
Susan, age 46, California
"I’ve been divorced for twelve years, and whenever I’m with a guy now, I ask him if he’s clean—and not everyone does ask—and then I just have to trust him. I was with this guy and he was like "I’m clean, I’m clean," so we stopped using a condom. Well weeks later, I came to find out through conversation that he had also been with another woman the entire time we’d been seeing each other, and they hadn’t been using protection either. I mean, he and I had never talked about being exclusive, but—I thought we were. And the other woman he was seeing thought they were too, and she freaked out because it was her first relationship after her divorce. So he and I both got tested right away, and we’re fine, but still, it’s scary. You can be as responsible as you want, but at some point, you’re going to trust someone—and you should trust people—but there will always be some risk to that."
From the Field: Clinicians and Researchers
Ben, age 39, Kenya
"I spend time in a clinic in Western Kenya. I see these women come in, most of whom are HIV infected, and I hear their stories. And I know that it is possible to actually bring down the level of new HIV infections around the world to near zero, and it is possible to empower women to take control of their health. What we’re trying to do is to make the easy choice the healthy choice. A woman should be able to go to her local shop and choose a product that suits her best—ideally there would be a multitude of products—that would either prevent HIV, bacterial vaginosis, and other STIs as well as prevent pregnancy or only prevent STIs if she was trying to get pregnant. These products will take time to get on the market—maybe a decade or more—but what we care about is just that they get there and start making a difference."